AAN 2024 | Outcomes in patients with MS who receive immune checkpoint inhibitors as cancer treatment

Immune checkpoint inhibitors (ICIs), a class of agents used in cancer treatment, are associated with immune-related adverse events (irAEs) in some patients, as well as exacerbation of pre-existing autoimmune diseases. Prashanth Rajarajan, MD, PhD, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, discusses the findings of a retrospective study aiming to investigate the neurologic outcomes of patients with multiple sclerosis (MS) who received ICIs as cancer treatment. Leveraging data from the electronic medical records of six sites in the US, Dr Rajarajan and his team were able to identify 65 patients who fit the desired criteria. This patient group had a median age of 66 years and low activity of their MS as a result of this, with a low incidence of flares, a low disability burden, and only one-third of patients receiving disease-modifying therapies (DMTs). Only two patients experienced an increase in MS activity while on ICIs – one had asymptomatic MRI lesions, and the second experienced worsening of gait and lesions, which resolved with steroid administration. The study also elucidated that patients with MS receiving ICIs are not at higher risk of neurologic irAEs than patients without MS receiving the same therapy. Dr Rajarajan highlights that these findings are reassuring but cannot be generalized to younger adults with MS who are likely to have more active disease. Therefore, the next steps in this area include studying a younger patient population, as well as patients with other conditions, such as neuromyelitis optica (NMO) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). This interview took place at the American Academy of Neurology (AAN) Annual Meeting 2024 in Denver, CO.

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